WRITE a paper (at least 750 words) on a Innovative Nursing Care Delivery Model. Read the two (2) articles below:
? Norlander, L. (Ed.). (2011). Transformational models of nursing across different care settings. Report: The future of nursing: Leading change, advancing health (Appendix G). Washington, DC: National Academy of Sciences, Institute of Medicine.
(CLICK on PDF file: TRANSFORMATIONAL NURSING MODELS)
NOTE: For this assignment, ignore curriculi/nurse education models
? Hughes, F. (2006). Nurses at the forefront of innovation. International Nursing Review, 53, 94-101.
(CLICK on PDF file: NURSING PRACTICE INNOVATIONS)
Baccalaureate-prepared nurses are expected to function as managers, educators, collaborators, advocates, and leaders within a variety of settings. These articles describe a variety of innovative or “transformational” models in nurse-managed care across various care settings. Another source of ideas are the vignettes and case studies found in your textbook chapters.
For this paper, you will develop an innovative nursing care delivery model for a vulnerable population, care specialty, and setting in the United States OR a low income global country that reflects nurse managed care, collaboration, care across settings, and technology.
For your paper, it is easiest to focus on one (1) population, one (1) health issue/disease, and one (1) type of setting within a country. Be specific. If you use a low income country, name your low income country (see list in module 1) and adjust your model to the disease(s) and conditions found within that country. Consider that low income countries will not have access to the same level of facilities, technology related to diagnostics and communication, medications, and the health care professionals found in the U.S.
? A vulnerable population can include low income children and/or adults; elderly; homeless; migrants; immigrants; racial & ethnic minorities, people with chronic health or terminal conditions/diseases (or any group at risk for obtaining appropriate health care).
? A care specialty can include preventative care; primary care; acute care; chronic care; palliative or end-of-life care (including the targeting of any disease or condition that results in a health risk).
??????????
? A setting can include rural or urban community housing and/or clinic; school; specialty unit in a hospital; emergency room; health provider office; armed services facility; rehabilitation facility; hospice facility; ambulatory health care center; client home; nursing home; prison or detention center; short term stay housing (or any setting where a vulnerable client/patient population is available for care).
a) Content of paper:
Title of Paper (top of page 2, centered) Innovative Nursing Care Delivery: [Name of Your Model]
PAPER HEADING: Introduction [Level 1] What is your model’s population, setting, care specialty, and your model’s goal(s) and/or purpose(s)? For example, are you targeting a particular group or disease/condition? Choose a name for your model and include it in your paper title.
PAPER HEADING: Description of the [Name of Your Model] [Level 2] You are welcome to use your creativity in the model–develop your own or base it on an existing model. For ideas, start with the articles found with the assignment, textbook (Global Health 101) scenarios, or do literature searches on the internet. However, be sure that the model is nurse-led or nurse-managed. Registered nurses have authority to make decisions regarding nursing diagnoses, interventions, and referrals. Registered nurse practitioners have additional authority related to medical diagnoses and interventions (prescriptions).
Be sure to include the themes crucial to meeting the challenges of the future: nurse- managed care, collaboration, continuity of care and technology in describing your model. Be aware of cost-effectiveness; you could develop the “Cadillac” of models, but no one would consider implementing it because the cost would be too high.
Nurse led and nurse managed health care. [Level 3] Were nurses instrumental in the development and implementation of your model? How is your model nurse managed? Are nurses consulted and/or make decisions re: budget, personnel, and the communication, referral, and evaluation processes?
Partnerships and collaboration. [Level 3] What partnerships and collaborations exist for your model? Are they at the professional level (i.e., social workers, nutritionists, community leaders) and/or the organizational level (home health care agencies, public health departments, hospitals)?
Continuity of care across settings. [Level 3] What happens when a patient/client moves to a different setting, i.e., home, hospital, hospice, clinic, emergency room, etc. How is communication handled so the patient/family needs are consistently met when moved across settings?
????????
Technology. [Level 3] What technology is used? Is it low-technology (basic assessment tools, screening tests) or high-technology (i.e, patient diagnostic, monitoring, and/or data processing systems) or a combination of both?
PAPER HEADING: Development/Implementation Team for the [Name of Your Model] [Level 2] Your team is important to carry out model’s goal(s). Depending on your model and setting, your team may include other registered nurses, nurse practitioners, community workers, nurse assistants, licensed practical nurses, nutritionists, physical therapists, occupational therapists, dentists, social workers, community leaders, psychologists, clergy, administrators, informatics technicians, physicians (if physicians are part of the team, they should function as consultants, not “captain of the ship”). Include your team members and briefly discuss their functions in carrying out the model goal(s)/purposes(s). How would communication and referrals be handled? Again–think about the cost effectiveness–could ancillary staff (nurse assistants, trained community workers) be used just as effectively?
PAPER HEADING: Evaluation of [Name of Your Model]: Outcome Measurement [Level 2] After implementation of the model, what outcomes would you measure Would you look at cost comparisons and/or savings? Patient satisfaction? Staff satisfaction? Fewer ER visits and/or re-hospitalizations? Decreased incidence of a particular disease/condition? Increased number of therapies? Increased knowledge of a disease or intervention?
For outcomes, be specific on what, who, when and how. For example, if you do a survey:
What type of survey is it (i.e., satisfaction, data gathering)?
Who would you survey (i.e., staff, patients, administrators)?
When would you do the survey (i.e., time period; pre/post tests)?
How would you conduct the survey (handout, mailing, computer analysis)?
b) An example of a nurse-managed model:
Below is an idea for a nurse-managed model. Your paper would be organized per the assignment instructions and more detailed regarding the health care delivery (nurse-led, collaboration/partnerships, continuity of care, and technology), and the functions of each of the team members, etc., but this is the start of an idea:
Let’s say you are a nurse working in community health and you are aware of three large migrant communities located in the rural areas around Homestead, Florida. The migrant workers who reside in these communities include their families–from infants to elderly. The communities are isolated and lack transportation and the ability to pay for and access local health care facilities.
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You develop a model named Bus Stop for Health. You obtain funding (donor and/or grant) to refurbish a bus or utilize a refurbished bus already owned by a local health care organization. The bus will include an examination room (with assessment devices, such as BP cuffs, otoscopes, exam tables), supplies for health screenings (i.e., diabetes, cholesterol, pap smears, etc.), and two rooms for consultation.
The purpose of the bus is to provide primary health care (preventative care, such as immunizations and well child exams), monitor chronic diseases (such as hypertension and diabetes), diagnose and treat minor illnesses, and provide health-related education for this population. A referral system will be established for specialty care, such as obstetrics. An informatics technician (IT) will establish a computerized (e-tablet) system to input, store, and access data in the field. Smart phones will be used for real time communication.
After consultation with and permission from the local community leaders in the migrant communities, the bus is scheduled to drive to and spend 1-2 days/week at each migrant community. Some folding chairs and a tarp will be carried in the bus so small covered outdoor or indoor health education sessions can be provided.
Regular team members on the bus will consist of a nurse practitioner, registered nurse, and receptionist/translator. Other team members will rotate in and out of the scheduled bus times on a regular basis. For example, you could include a social worker and dentist, (describe their specific functions/purposes for this migrant population) as rotating team members. A nurse midwife could also be included in the bus rotation for managing low risk pregnancies. A consultant and referral relationship with a physician or physicians could be established for more complicated health care problems. Commonly prescribed medications can often be obtained through pharmacies at reduced costs or free from donors.
Evaluation? Some outcomes looked at could be increased immunization rates, increased knowledge related to common chronic diseases, child safety, etc. (by using pre & post tests), reduced visits to the local ERs for minor illnesses), earlier prenatal care, or other outcomes of interest. You could also use surveys to determine patient and community leader satisfaction with the model.
c) In-text citations and a reference list MUST be found in your paper. See the Nursing Student Writing Guidelines Checklist for APA formatting.
d) UPLOAD completed paper (file) into the Assignment TURNITIN folder by the due date.
e) WRITING EVALUATION: See rubric on Course Content page
Paper: Innovative Nursing Care Delivery (750 words min)
Innovative Nursing Care Model; Development/Implementation Team for Innovative Nursing Care Model; Evaluation of Model: Outcome Measurement
Critical Thinking Skills (15 pts); Content Development (15 pts); Organization (15 pts)
???
References (15 pts); Format (15 pts); Computer/Technology Skills (25 pts)
Child Welfare Intervention and LGBTQ Youth
UncategorizedQuestion Description
The Research Term Paper Assignment
Social Work 110 requires all students to write a 5-6 page scholarly research term paper on a field of service in the social work profession, in American Psychological Association (APA) format.
*** You can narrow your focus: For example: If your topic is Criminal Justice and Corrections, you could focus on the specific area of Juvenile Delinquency ***
III. What Are The Research Requirements?
*Please be sure that all resources include author/s and dates. Undated books, articles or websites will not be accepted.
http://cuyamaca.libguides.com/socialwork (Links to an external site.)Links to an external site.
>Nursing homework help
UncategorizedYou are working in an ICU where a 16-year-old girl is in critical condition after an auto accident. Her mother comes in and begins to sing, sprinkle tobacco around the bed, hang eagle feathers and crystals around the room, and move her hands back and forth above the girl’s body. The girl’s nurse tells the mother that visiting time is over and that she should take all these dirty things out of the room. The mother insists on staying by the bedside and says that if she had placed rosary beads or Bibles in the room she would not have been questioned.
What cultural and spiritual issues are evident in this situation?
Cultural care is a type that involves the delivery of care in a non-conventional where care should be delivered in a way to accommodate the patient’s preference. The way that transcends cultural boundaries and considers a client’s culture as it affects health, illness and lifestyle, communication, dietary preferences, and dress are influenced. In this case, hang eagle feathers and crystals around the room can be accommodated if it will not interfere with scientific care.
Apply cultural competence to this case
Cultural competence is the ability of nurses to understand and address the entire cultural context of each client within the realm of the care they deliver. The nurse should be able to allow cultural exceptions for the patient and her mother. The patient’s mother’s faith was tied to the artifacts that she brought and will help the girl get better the moment she sees those things.
Discuss complementary therapies evident in this situation
In this situation, the mother is applying holistic/cultural care to the conventional scientific care the nurse is providing. This accommodation is will enhance nurse-patient interaction and relationships.
How would you incorporate spiritual care?
Nurses can provide spiritual care by attending to several important spiritual elements. This includes supporting the patient’s spiritual beliefs and needs and individualizing spiritual care to the patient. I would start by taking cues from the patient including but not limited to asking for the patient’s preferences. Also, supporting the patient within the limits of their faith and share encouraging thoughts or words.
How would you approach this situation?
I will approach this situation with caution and respect. I will create accommodations with the hospital policy in mind. By attending to the patient’s several important spiritual elements. The patient’s family acknowledges the higher powers and believes in the intervention of higher power. I will not stand in the way.
What principles would guide you?
I will base my guide on the ethical principles of patient-centeredness, holism, discretion, accompaniment, and tolerance. These are the core principles that guide spiritual care.
References
Hodge, D. R., & Limb, G. E. (2011). Spiritual assessment and Native Americans: establishing the social validity of a complementary set of assessment tools. Social Work, 56(3), 213–223.https://doi-org.resu.idm.oclc.org/login.aspx?direct=true&db=mdc&AN=21848086&site=ehost-live
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UncategorizedPlease answer the following attached question, if you would? It is due in the next 24 hours. Thanks so much.
Compare three different methods of analyzing YOUR body weight/body composition
Nursing HomeworksBody Composition Assignment
Compare three different methods of analyzing YOUR body weight/body composition. One of the three methods must be the Body Mass Index. Additional methods include, but are not limited to; skin fold analysis, underwater/hydrostatic weighing, electrical impedance, height-weight chart, military measurements, BodPod, etcetera.
What three methods did you choose?
What is your score or # for each of the readings?
What is considered healthy?
Are you in the healthy range for all three methods?
What can someone do to improve their measurements if they are not in a healthy range?
Need a place to get measured? Come by our state-of-the-art fitness center and they can do BMI and electrical impedence for you, find a third measurement somewhere else and you are set.
Peritonitis following ruptured appendix
UncategorizedNRSG370: Melody King, 36, Peritonitis following ruptured appendix – Nursing Assignment
Ms Melody King presented to the Emergency Department with 2-3 days of severe Left Lower Quadrant abdominal pain, which required emergency laparoscopic surgery for removal of a ruptured appendix. She has a past medical history of asthma and depression, with her current prescribed and compliant medications list which includes:
* Ventolin
*Seretide
* Sertraline
Melody’s observations were as follows:
* BP 95/45mmHg
* HR 120
* Temp 38.3°Celcius
* RR 22/min and shallow
*SpO 2 95% on room air
She complained of increasing nausea and centralised abdominal pain 7-8 on a scale of 0 to10. The physical assessment showed a distended abdomen and generalised abdominal guarding. To investigate her condition further, pathology results reveal a raised white blood cell (WBC) count and CRP.
Questions:
• Considering the person’s situation, collect, process and present related health information;
• Identify and prioritise at least three (3) nursing problems/issues based on the health assessment data that you have identified for the person at the centre of care;
• Establish goals for priority of nursing care as related to the nursing problem/issues identified;
• Discuss the nursing care of the person, link it to assessment data and history;
• Evaluate your nursing care strategies to justify the nursing care provided;
• Reflect on the person’s outcomes.
3) Describe the evaluation goal and viewpoint that will guide your own evaluation plan. Provide your rationale.
Nursing Essay HelpApplication: Evaluation Project Part 1: Evaluation Plan Focus Technology increases human effectiveness. Using a lever, you can move an object several times your size. In an airplane, you can move exponentially faster than on foot. Using the Internet, you can access information much more quickly than at a library. What possibilities like this exist in the nursing field? What health information technologies can amplify your impact as a nurse far more than ever before? In this Evaluation Project, you will have the opportunity to answer these questions. Because of the great differences between HIT systems and different goals of an evaluation, there is no one-size-fits-all evaluation plan. Different technologies require different evaluation methods. Consequently, in this part of your Evaluation Project, you will conduct research on how system implementations similar to the one you select have been previously evaluated. After exploring similar system implementations, you will select one research goal and viewpoint to use in the evaluation. Read the following three scenarios, and select the one that is of most interest to you: Scenario 1: Your hospital is implementing a new unified acute and ambulatory Electronic Health Record (EHR) system through which patient care documentation will occur. Interdisciplinary assessment forms (including nursing), clinical decision support, and medical notes will be documented in this system. The implementation of the system is anticipated to improve the hospital’s performance in a multitude of areas. In particular, it is hoped that the use of the EHR system will reduce the rate of patient safety events, improve the quality of care, deter sentinel events, reduce patient readmissions, and impact spending. The implementation of the EHR system is also intended to fulfill the “Meaningful Use” requirements stipulated in the Health Information Technology for Economic and Clinical Health (HITECH) Act. As the hospital’s lead nurse informaticist, you have been tasked with planning the evaluation of the EHR implementation. Scenario 2: As the lead nurse informaticist in your hospital, you have been given the task of planning an evaluation for a soon-to-be launched computerized provider order entry (CPOE) system. The CPOE system is designed to replace conventional methods of placing medication, laboratory, admission, referral, and radiology orders. CPOE systems enable health care providers to electronically specify orders, rather than rely on paper prescriptions, telephone calls, and faxes. The intended goal of a CPOE system is to improve safety by ensuring that orders are easily comprehensible through the use of evidence-based order sets. In addition, the CPOE system has the potential for improving workflow by avoiding duplicate orders and reducing the steps between those who place medical orders and their recipients. Scenario 3: You are the lead nurse informaticist in a large urban hospital that has recently implemented a new Electronic Medication Administration Record (eMAR) and Bar Code Medication Administration (BCMA) system. The BCMA system uses bar coding technology to facilitate the correct identification of patients at the point of administration of medications. BCMA will be used for all medications—tables, injections, and intravenous treatment. You have been selected to conduct an evaluation of the new system. The eMAR is designed to utilize the medication order entry process in order to expedite the creation of the 24-hour medication administration record, whereas the BCMA will automate administration documentation. In addition, the system is intended to reduce medication administration errors by tracking and alerting health care providers about dosages, proper administration times, medication allergies, or medication incompatibilities. To prepare:
- Select one scenario to use for the Evaluation Project.
- Consider what viewpoint and research goal you would use to guide your evaluation plan. Although many potential research goals or viewpoints could be selected for each scenario, you are only required to choose one goal and one viewpoint. The scenario you select will be used for the Evaluation Project throughout this course. To maximize your benefit from this project, consider selecting a scenario that is relevant to a health care organization with which you are involved.
- Research published evaluations that have been conducted on HIT system implementations similar to the one in the scenario you selected.
To complete Part 1 of this Evaluation Project: By Friday 12/23/2016 1) In a 3-page paper, identify which of the three hypothetical health information technology systems you will be evaluating in this project, and explain why you selected this system. 2) Summarize your research findings on similar HIT implementations. 3) Describe the evaluation goal and viewpoint that will guide your own evaluation plan. Provide your rationale. Required Readings Friedman, C. P., & Wyatt, J. C. (2010). Evaluation methods in biomedical informatics (2nd ed.). New York, NY: Springer Science+Business Media, Inc. Chapter 2, “Evaluation as a Field” (pp. 21–47) This chapter defines evaluation and shows how it differs from research. The chapter also includes a discussion the philosophy behind evaluation and the multiple approaches to evaluation. Board on Health Care Services. (2012). Health IT and patient safety: Building safer systems for better care. The National Academies Press: Washington DC. Retrieved from http://www.nap.edu/catalog.php?record_id=13269 Chapter 2, “Evaluating the Current State of Patient Safety and Health IT” (pp. 31–58) This chapter addresses the challenges of evaluation in health information technology due to the complex nature of technology and rapid changes in the field. The chapter also identifies barriers to evaluation and the threats posed to patient safety by a lack of evaluation. Nursing Documentation]]>Present a Manage Care Control Cost Plan: Under traditional indemnity insurance, assignment help
UncategorizedQuestion Description
generate, designate, Organize, investigate and, present a Manage Care Control Cost Plan: Under traditional indemnity insurance, the money follows the patient. Patients select health care providers and visit them as they choose. Providers then bill the private insurer or public payer and are reimbursed on a fee-for-service or per case basis
. Introduction (30%) Provide a short-lived outline of the meaning (not a description) of Chapter 9 and 10 and articles you read, in your own words. Types and classifications of managed care models.
2. Manage Care Control Cost Plan: (50%)
a. Cost savings
‘‘Structural changes centered around the expansion of managed care have been the major transformative force in health markets in recent years and have played a major role in restraining growth in health spending’’
b. Provider reimbursement
This complaint has two dimensions: hospital profitability, and physician compensation. As far as hospitals are concerned, administrators are worried about profitability or surplus for reinvestment, and consumers are worried about the threat of hospital closures. Few things stir as much public outcry as the prospect of closing a community hospital.
c. Quality of care
Much recent legislation and many legal reforms havebeen aimed at preventing managed care’s perceivedquality abuses. The Patient Bill of Rights, which hasbeen heavily debated in Congress, defines, amongother things, the rights of consumers with complexconditions to access directly a qualified specialist,continuity of provider for patients who are underregular treatment, and self-referral to certain types ofspecialists.
3. Conclusion (20%)
Quickly recapitulate your thoughts & statement to your critique of the articles and Chapter you read. How did these articles and Chapters impact your thoughts about Manage Care? What did you learn about manage care and how you will apply all these knowledge?
Evaluation will be based on how clearly you respond to the above, in particular:
a) The precision with which you analyses the articles;
b) The complexity, possibility, and organization of your paper; and,
c) Your conclusions, including a description of the impact of these articles and Chapters on any Health Care Setting.
feedback process in which the output of a given system is returned to the system health dynamic state in which individuals adapt to their internal and external environments
Uncategorizedfeedback process in which the output of a given system is returned to the system health dynamic state in which individuals adapt to their internal and external environments so there is a state of physical, emotional, intellectual, social, and spiritual well-being domain the perspective of a profession that provides the subject, central concepts, values and beliefs, phenomena of interest, and central problems of a discipline paradigm a pattern of thought that is useful in describing the domain of a discipline. person the recipient of nursing care, including individual patients, groups, families, and communities nursing the diagnosis and treatment of human responses to actual or potential health problems theory designed to explain a phenomenon such as self-care or caring nursing theory a conceptualization of some aspect of nursing that describes, explains, predicts, or prescribes nursing care phenomenon the term, description, or label given to describe an idea or responses about an event, a situation, a process, a group of events, or a group of situations assumptions the “taken for granted” statements that explain the nature of the concepts, definitions, purpose, relationships, and structure of a theory grand theories theories that are systemic and broad in scope, complex, and therefore require further specification through research middle-range theories theories that are more limited in scope and less abstract. They address a specific phenomenon and reflect practice descriptive theories theories that are the first level of theory development. They explain, relate, and in some situations predict nursing phenomena prescriptive theories theories that address nursing interventions for a phenomenon, describe the conditions under which the prescription occurs, and predict the consequences interdisciplinary theory theory that explains a systematic view of a phenomenon specific to the discipline of inquiry feedback serves to inform a system about how it functions Leininger’s the main concept of __ theory is cultural diversity, and the goal of nursing care is to provide the patient with culturally specific care Neuman the __ systems model is based on stress and the client’s reaction to the stressor. The role of nursing is to stabilize the patient Nightingale theory goal is to facilitate the reparative processes of the body by manipulating the patient’s environment Peplau theory goal is to develop interaction between nurse and patient Henderson theory goal is to work independently with other health care workers, assisting patient in gaining independence as quickly as possible; help patient gain lacking strength Orem theory goal is to care for and help patient attain total self-care King theory goal is to use communication to help patient reestablish positive adaptation to environment Neuman theory goal is to help individuals, families, and groups attain and maintain maximal levels of total wellness by purposeful interventions Leininger theory goal is to provide care consistent with nursing’s emerging science and knowledge with caring as central focus Roy theory goal is to identify types of demands placed on patient, assess adaptation to demands, and help patient adapt Watson theory goal is to promote health, restore patient to health, and prevent illness Benner and Wrubel theory goal is to focus on patient’s need for caring as a means of coping with stressors of illness the person, health, environment/situation, and nursing components of the paradigm of nursing explain a phenomenon a theory is a set of concepts, definitions, relationships, and assumptions that: Orem A patient with diabetes is controlling the disease wit insulin and diet. The nursing health care provider is focusing efforts to teach the patient self-management. What nursing theory is useful in promoting self management? describe or predict patient outcomes theory-based nursing practice uses a theoretical approach for nursing care. This approach moves nursing forward and a science. This suggests that theories will be tested to: interdisciplinary to practice in today’s health care environment, nurses need a strong scientific knowledge base from nursing and other disciplines such as the physical, social, and behavioral sciences. This statement identifies the need for which theory? developmental __ theories describe the life processes of an older adult facing chronic illness nursing and related sciences, standards of practice a nurse is applying Henderson’s theory as basis for theory based-nursing practice. What elements are important for theory-based nursing practice? theory-generating __ research identifies observations or describes a phenomena. It contributes to the scientific knowledge base of nursing. prescriptive __ theories address specific nursing interventions and predict the patient response experimental and nonexperimental research and research from other disciplines as an art nursing relies on knowledge gained from practice and reflection on past experiences. As a science nursing relies on.
NURSING
Nursing HomeworksNURSING
This assignment is due on Wednesday February 20, 2013 at 6 AM EST . It is very important to read and respond to all questions clearly using APA format. This assignment is in sections and each sections must be clearly indicated with separate reference list all in APA format. It is critical that in text citation be use throughout the entire assignment , and proper grammar must also be used. The similarity scores cannot be more than 15% and you should avoid cutting and pasting as this will be check. All external sources should be cited. (Base on U.S Healthcare system).
SECTION A
This section should contain a minimum of 400 words document all in APA format , in text citation is critical and the similarity scores cannot be more than 15%. All the questions below must be clearly responded to and a reference list included at the end of this section.
You are discussing the quality improvement process with a colleague so that the colleague gains a better understanding of the process. Address the following:
As either a participant, an implementer, or as an effected person, discuss 1 quality improvement process that you have had exposure to or experience with in a heath care setting.
Briefly compare the pros and cons of 2 quality improvement processes that are used in health care.
SECTION B
This section should contain a minimum of 400 words document all in APA format , in text citation is critical and the similarity scores cannot be more than 15%. All the questions below must be clearly responded to and a reference list included at the end of this section.
Address the following:
Describe a time when you felt patient care could be improved in some way.
Share any problems that you have encountered with patient care, and what your ideas were—or are—to help provide a solution to these problems.
Find, cite, and reference an article that supports your conclusions about the patient care problem that you have identified.
Summarize the article’s purpose and…
Innovative Nursing Care Delivery
UncategorizedWRITE a paper (at least 750 words) on a Innovative Nursing Care Delivery Model. Read the two (2) articles below:
? Norlander, L. (Ed.). (2011). Transformational models of nursing across different care settings. Report: The future of nursing: Leading change, advancing health (Appendix G). Washington, DC: National Academy of Sciences, Institute of Medicine.
(CLICK on PDF file: TRANSFORMATIONAL NURSING MODELS)
NOTE: For this assignment, ignore curriculi/nurse education models
? Hughes, F. (2006). Nurses at the forefront of innovation. International Nursing Review, 53, 94-101.
(CLICK on PDF file: NURSING PRACTICE INNOVATIONS)
Baccalaureate-prepared nurses are expected to function as managers, educators, collaborators, advocates, and leaders within a variety of settings. These articles describe a variety of innovative or “transformational” models in nurse-managed care across various care settings. Another source of ideas are the vignettes and case studies found in your textbook chapters.
For this paper, you will develop an innovative nursing care delivery model for a vulnerable population, care specialty, and setting in the United States OR a low income global country that reflects nurse managed care, collaboration, care across settings, and technology.
For your paper, it is easiest to focus on one (1) population, one (1) health issue/disease, and one (1) type of setting within a country. Be specific. If you use a low income country, name your low income country (see list in module 1) and adjust your model to the disease(s) and conditions found within that country. Consider that low income countries will not have access to the same level of facilities, technology related to diagnostics and communication, medications, and the health care professionals found in the U.S.
? A vulnerable population can include low income children and/or adults; elderly; homeless; migrants; immigrants; racial & ethnic minorities, people with chronic health or terminal conditions/diseases (or any group at risk for obtaining appropriate health care).
? A care specialty can include preventative care; primary care; acute care; chronic care; palliative or end-of-life care (including the targeting of any disease or condition that results in a health risk).
??????????
? A setting can include rural or urban community housing and/or clinic; school; specialty unit in a hospital; emergency room; health provider office; armed services facility; rehabilitation facility; hospice facility; ambulatory health care center; client home; nursing home; prison or detention center; short term stay housing (or any setting where a vulnerable client/patient population is available for care).
a) Content of paper:
Title of Paper (top of page 2, centered) Innovative Nursing Care Delivery: [Name of Your Model]
PAPER HEADING: Introduction [Level 1] What is your model’s population, setting, care specialty, and your model’s goal(s) and/or purpose(s)? For example, are you targeting a particular group or disease/condition? Choose a name for your model and include it in your paper title.
PAPER HEADING: Description of the [Name of Your Model] [Level 2] You are welcome to use your creativity in the model–develop your own or base it on an existing model. For ideas, start with the articles found with the assignment, textbook (Global Health 101) scenarios, or do literature searches on the internet. However, be sure that the model is nurse-led or nurse-managed. Registered nurses have authority to make decisions regarding nursing diagnoses, interventions, and referrals. Registered nurse practitioners have additional authority related to medical diagnoses and interventions (prescriptions).
Be sure to include the themes crucial to meeting the challenges of the future: nurse- managed care, collaboration, continuity of care and technology in describing your model. Be aware of cost-effectiveness; you could develop the “Cadillac” of models, but no one would consider implementing it because the cost would be too high.
Nurse led and nurse managed health care. [Level 3] Were nurses instrumental in the development and implementation of your model? How is your model nurse managed? Are nurses consulted and/or make decisions re: budget, personnel, and the communication, referral, and evaluation processes?
Partnerships and collaboration. [Level 3] What partnerships and collaborations exist for your model? Are they at the professional level (i.e., social workers, nutritionists, community leaders) and/or the organizational level (home health care agencies, public health departments, hospitals)?
Continuity of care across settings. [Level 3] What happens when a patient/client moves to a different setting, i.e., home, hospital, hospice, clinic, emergency room, etc. How is communication handled so the patient/family needs are consistently met when moved across settings?
????????
Technology. [Level 3] What technology is used? Is it low-technology (basic assessment tools, screening tests) or high-technology (i.e, patient diagnostic, monitoring, and/or data processing systems) or a combination of both?
PAPER HEADING: Development/Implementation Team for the [Name of Your Model] [Level 2] Your team is important to carry out model’s goal(s). Depending on your model and setting, your team may include other registered nurses, nurse practitioners, community workers, nurse assistants, licensed practical nurses, nutritionists, physical therapists, occupational therapists, dentists, social workers, community leaders, psychologists, clergy, administrators, informatics technicians, physicians (if physicians are part of the team, they should function as consultants, not “captain of the ship”). Include your team members and briefly discuss their functions in carrying out the model goal(s)/purposes(s). How would communication and referrals be handled? Again–think about the cost effectiveness–could ancillary staff (nurse assistants, trained community workers) be used just as effectively?
PAPER HEADING: Evaluation of [Name of Your Model]: Outcome Measurement [Level 2] After implementation of the model, what outcomes would you measure Would you look at cost comparisons and/or savings? Patient satisfaction? Staff satisfaction? Fewer ER visits and/or re-hospitalizations? Decreased incidence of a particular disease/condition? Increased number of therapies? Increased knowledge of a disease or intervention?
For outcomes, be specific on what, who, when and how. For example, if you do a survey:
What type of survey is it (i.e., satisfaction, data gathering)?
Who would you survey (i.e., staff, patients, administrators)?
When would you do the survey (i.e., time period; pre/post tests)?
How would you conduct the survey (handout, mailing, computer analysis)?
b) An example of a nurse-managed model:
Below is an idea for a nurse-managed model. Your paper would be organized per the assignment instructions and more detailed regarding the health care delivery (nurse-led, collaboration/partnerships, continuity of care, and technology), and the functions of each of the team members, etc., but this is the start of an idea:
Let’s say you are a nurse working in community health and you are aware of three large migrant communities located in the rural areas around Homestead, Florida. The migrant workers who reside in these communities include their families–from infants to elderly. The communities are isolated and lack transportation and the ability to pay for and access local health care facilities.
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You develop a model named Bus Stop for Health. You obtain funding (donor and/or grant) to refurbish a bus or utilize a refurbished bus already owned by a local health care organization. The bus will include an examination room (with assessment devices, such as BP cuffs, otoscopes, exam tables), supplies for health screenings (i.e., diabetes, cholesterol, pap smears, etc.), and two rooms for consultation.
The purpose of the bus is to provide primary health care (preventative care, such as immunizations and well child exams), monitor chronic diseases (such as hypertension and diabetes), diagnose and treat minor illnesses, and provide health-related education for this population. A referral system will be established for specialty care, such as obstetrics. An informatics technician (IT) will establish a computerized (e-tablet) system to input, store, and access data in the field. Smart phones will be used for real time communication.
After consultation with and permission from the local community leaders in the migrant communities, the bus is scheduled to drive to and spend 1-2 days/week at each migrant community. Some folding chairs and a tarp will be carried in the bus so small covered outdoor or indoor health education sessions can be provided.
Regular team members on the bus will consist of a nurse practitioner, registered nurse, and receptionist/translator. Other team members will rotate in and out of the scheduled bus times on a regular basis. For example, you could include a social worker and dentist, (describe their specific functions/purposes for this migrant population) as rotating team members. A nurse midwife could also be included in the bus rotation for managing low risk pregnancies. A consultant and referral relationship with a physician or physicians could be established for more complicated health care problems. Commonly prescribed medications can often be obtained through pharmacies at reduced costs or free from donors.
Evaluation? Some outcomes looked at could be increased immunization rates, increased knowledge related to common chronic diseases, child safety, etc. (by using pre & post tests), reduced visits to the local ERs for minor illnesses), earlier prenatal care, or other outcomes of interest. You could also use surveys to determine patient and community leader satisfaction with the model.
c) In-text citations and a reference list MUST be found in your paper. See the Nursing Student Writing Guidelines Checklist for APA formatting.
d) UPLOAD completed paper (file) into the Assignment TURNITIN folder by the due date.
e) WRITING EVALUATION: See rubric on Course Content page
Paper: Innovative Nursing Care Delivery (750 words min)
Innovative Nursing Care Model; Development/Implementation Team for Innovative Nursing Care Model; Evaluation of Model: Outcome Measurement
Critical Thinking Skills (15 pts); Content Development (15 pts); Organization (15 pts)
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References (15 pts); Format (15 pts); Computer/Technology Skills (25 pts)